Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1737-226 | WI |
NPI | 1003245283 |
---|---|
Provider Name | Angela Byers |
First Address | Waukesha, WI 53186-2834 |
Second Address | Wauwatosa, WI 53226-1505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2013 |
Last Update Date | 07/11/2013 |